Assessment of Perception of Pain with E-Speed Film, CCD Sensor and Photostimulable Phosphor Plates for Intraoral Radiographs in Children using Three Pain Rating Scales.

BACKGROUND: Dental radiography is an integral part of intraoral evaluation. Children are often uncomfortable during the placement of film or sensor due to the impingement of the soft tissues. Thus, the perception of pain with three intraoral radiographic methods in children was evaluated using three subjective pain rating scales. AIM: To evaluate the discomfort with three different techniques, that is, intraoral periapical (IOPA) radiograph, charge-coupled device (CCD), and photostimulable phosphor (PSP) luminescence (PSPL), using the Wong-Baker Faces Pain Rating Scale (WBFPRS), numerical rating scale, and visual analog scale (VAS). MATERIALS AND METHODS: A sample of 35 children aged 6-12 years were divided into two groups: group 1 (6-8 years) and group 2 (9-12 years). For each child, simulations of the three radiological methods (IOPA, CCD, and PSPL) were performed. The meaning of each facial expression on the WBFPRS, VAS, and the numbers on the numerical rating scale was explained to each child before the procedure. STATISTICAL ANALYSIS USED: A one-way analysis of variance (ANOVA) test and paired-samples t-test are used. RESULTS: The results revealed that the CCD sensors elicited higher pain scores than those obtained with IOPA and PSPL, whereas the IOPA film showed the least pain score. Higher score values were obtained in group 1 than in group 2, indicating that children aged 6-8 years felt higher discomfort than the 9- to 12-year age group for the same procedure. This difference was statistically significant (P < 0.001). CONCLUSION: It was concluded that conventional IOPA films were tolerated better by children when compared to PSP plates and CCD sensors.

An Evaluation of Biomechanical Preparation of Root Canals using Protaper Hand File, Mtwo NiTi Rotary File and NeoNiTi Single File Systems with Cone Beam Computed Tomography - An in Vitro Study.

Background: Root canal therapy is the most widely accepted treatment modality for pulpally involved teeth. Rotary NiTi instruments improve the root canal preparation because of the unique properties of the alloy. Cone beam computed tomography (CBCT) permits non-destructive and metrically exact analyses of variable such as volume, surface area, cross sectional shape, and taper. Thus the present study was conducted to evaluate the effect of biomechanical preparation of root canals using different file systems on cervical dentinal thickness at coronal level; canal transportation, and surface area at coronal, middle and apical levels using CBCT. Methodology: Forty-five single rooted premolars were randomly divided into three groups (n=15), (Protaper hand file, MtwoNiTi rotary file and NeoNiTi single file). CBCT scans were taken before and after the preparation. Dentinal thickness was measured in all four directions to assess cervical dentin thickness and canal transportation. Surface area was evaluated in Adobe Photoshop both before and after preparation. Results: The data obtained was subjected to statistical analysis. The total mean change in cervical dentin thickness and total mean canal transportation at coronal and apical was found to be maximum in Group III. The maximum increase of surface area was observed in Group I at coronal level whereas in Group III at middle and apical levels. Conclusion: It was concluded that the change in cervical dentin thickness was maximum in Group III. The canal transportation at coronal level and apical level was found to be maximum in Group III; at middle level it was maximum in Group II. The maximum increase of surface area at coronal level was observed in Group I, at middle and apical levels it was seen in Group III.

Applicability of Tanaka-Johnston, Moyers, and Bernabé and Flores-Mir Mixed Dentition Analyses in School-going Children of Sri Ganganagar City, Rajasthan (India): A Cross-sectional Study.

BACKGROUND: The orthodontic diagnosis and treatment planning are the fundamental goals during the mixed dentition period. Numerous methods have been proposed till date such as Nance method, Moyer's method, Staley-Kerber and Tanaka-Johnston's method, and Bernabé and Flores-Mir method. AIM: The aim of the study is to determine the mesiodistal widths of the lower permanent canines and premolars from Tanaka-Johnston, Moyers, and Bernabé E and Flores-Mir C mixed dentition analysis and to determine the correlation coefficients and the new prediction equation for Sri Ganganagar population. SETTING AND DESIGN: A total of 3572 children were clinically examined from the contemporary population of Sri Ganganagar city and Outpatient Department of Pediatric and Preventive Dentistry in Sri Ganganagar, Rajasthan. A total of 150 individuals were randomly selected for the study based on the inclusion and exclusion criteria and were designated as "study samples. MATERIALS AND METHODS: A total of 150 children aged 11-16 years of Sri Ganganagar city were randomly selected. The mesiodistal width of permanent incisors, canines, premolars, and molars was measured with the help of digital vernier caliper with an accuracy of ±0.01 mm. The measurements of canines and premolars were summed up and compared with those derived from Tanaka and Johnston equations, Moyers probability tables, and Bernabé and Flores-Mir equations. STATISTICAL ANALYSIS: The data obtained were subjected to statistical analysis using IBM SPSS Statistics Windows version "20.0" using Student's t-test, Pearson correlation coefficient, and Kruskal-Wallis test. RESULTS: All the three methods overestimated the actual sum of permanent canine and premolars in both the arches in our population. The correlation coefficients and the new regression equations were derived for both maxilla and mandible in males and females for Sri Ganganagar population. CONCLUSION: The predicted values obtained from all the three methods overestimated the actual values.

A comparative evaluation of microleakage and compressive strength of Ketac Molar, Giomer, Zirconomer, and Ceram-x: An in vitro study.

BACKGROUND: Microleakage around dental restorative material and strength to withstand the masticatory forces is major problem in dentistry. Instead, many new materials available, very few actually bond to tooth surface and bear masticatory load. AIM: The aim of this study is to evaluate and compare the microleakage and compressive strength of Ketac Molar, Giomer, Zirconomer, and Ceram-x. MATERIALS AND METHODS: For the evaluation of microleakage, Class V cavities were prepared on sixty human premolar teeth and divided into four study groups (n = 15): Group I (Ketac Molar), Group II (Giomer), Group III (Zirconomer), and Group IV (Ceram-x). The samples were thermocycled and subjected to dye penetration test. The sections were made and evaluated under stereomicroscope at × 40 magnification. For the compressive strength evaluation, sixty cylindrical specimens were fabricated measuring 5 mm × 6 mm and grouped into four study groups (n = 15): Group I (Ketac Molar), Group II (Giomer), Group III (Zirconomer), and Group IV (Ceram-x). All were then subjected to the Universal Testing Machine at crosshead speed of 1 mm/s. STATISTICAL ANALYSIS USED: The data were analyzed using paired t-test and ANOVA. RESULTS: The microleakage was found insignificant (P > 0.05) for all study groups, with Giomer showing maximum followed by Zirconomer, Ceram-x, and Ketac Molar. The compressive strength was found to be highly significant (P < 0.01) with the maximum score for Giomer followed by Ceram-x, Zirconomer, and Ketac Molar. CONCLUSION: The sealing ability was maximum in Ketac Molar, Zirconomer, Ceram-x, and Giomer whereas the compressive strength was maximum for Giomer followed by Ceram-x, Zirconomer, and Ketac Molar.

A Comparative Evaluation of Sealing Ability of New MTA Based Sealers with Conventional Resin Based Sealer: An In-vitro Study.

INTRODUCTION: Root canal obturation is the most important step in the root canal treatment that aims to obtain a complete hermetic seal and to prevent the re-growth of microorganisms in the root canal system. To accomplish this, many endodontic obturation materials and sealers are being used. AIM: To evaluate and compare the apical microleakage of a resin based sealer; Adseal with Mineral Trioxide Aggregate (MTA) based sealers; Pro root MTA and MTA Fillapex. MATERIALS AND METHODS: Total 75 extracted human single rooted teeth were taken and decoronated at cemento-enamel junction. The access cavities and biomechanical preparation were performed using endodontic rotary system. The teeth were randomly divided into five groups with n=15; Group I - Gutta-percha and Adseal sealer; Group II - Gutta-percha and MTA Fillapex; Group III- Gutta-percha and Pro root MTA; Group IV- Gutta-percha without sealer (positive control group); Group V- Root canal remained empty (negative control). All the specimens were stored at 37(0)C with 100% humidity for one week. All root surfaces except the apical 2mm were covered with two layers of nail varnish and then immersed in an aqueous solution of 2% methylene blue dye for 72 hours. Roots were longitudinally split using a diamond disk. Linear apical dye penetration was measured under Stereomicroscope at 40X magnification. STATISTICAL ANALYSIS: The data obtained was subjected to statistical analysis using paried t-test, ANOVA for interclass comparison, with SPSS statistical software (version 20.0). RESULTS: The intraobserver reliability was found to be insignificant in each of the triplicate study of all the three study samples. MTA Fillapex group showed maxmium apical microleakage followed by Pro root MTA and Adseal sealer. CONCLUSION: The results concluded that Adseal sealer showed minimal dye penetration followed by Pro root MTA and MTA Fillapex. Thus, concluding that Adseal sealer is better in apical sealing than Pro root MTA and MTA Fillapex.

Comparative evaluation of three mixed dentition analyses and formulation of regression equations for north Indian population: A cross-sectional study.

BACKGROUND: The present study was undertaken to evaluate the accuracy of methods proposed by Tanaka and Johnston, Moyers, and Bernabé and Flores-Mir to forecast the mesiodistal dimensions of permanent canine and premolars in a North Indian population. METHODS: Mesiodistal tooth dimensions were measured from study models representing 68 male and 68 female subjects (aged 12-16 years) of North Indian descent. The mesiodistal dimensions of the teeth were measured using a digital Vernier caliper (providing measurements to 0.01 mm accuracy). The measurements of canine and premolars were summed up and compared with those derived from Tanaka and Johnston equations, Moyers probability tables (75 th percentile), and Bernabé and Flores-Mir equations. RESULTS: All the three methods exhibited overestimation of actual sum of permanent canine and premolars in both the arches and genders in this population. Because of the discrepancy observed, new regression analyses in the form of Y = A + B (X) were formulated similar to those proposed by Tanaka and Johnston originally, but separately for males and females. In males, the correlation coefficient between the sum of mesiodistal widths of mandibular incisors and the sum of widths of canine and premolars was 0.637 and 0.685 for maxilla and mandible, respectively. This value was 0.55 for maxilla and 0.64 for mandible in females. These values were found to be statistically significant. CONCLUSION: All the methods evaluated in the study were found to be inaccurate and they overestimate the mesiodistal widths of permanent canine and premolars in North Indian population. Revised linear regression equations were derived using the data obtained from this population.

Clinical Course and Treatment of a Triplication Defect: A Case Report.

Fusion is an anomaly manifested in both deciduous and permanent dentitions. Fusion of dental tissues in the primary dentition is of clinical significance owing to the challenges in treatment of the affected teeth and aberrations encountered in development and eruption of their successors. Triple tooth refers to the union of three separate tooth entities. It can occur by fusion, germination, concrescence or a combination of both fusion and germination. Triplication is rarely encountered in the deciduous dentition. The case presented herein describes triplication of deciduous incisors and a supernumerary tooth. The diagnosis was confirmed with the help of radiographs, computed tomography (CT) imaging and histological examination. Retention of the triple tooth had led to crossbite. Extraction was performed for the triple tooth and crossbite was corrected using a composite inclined plane.

Retrieval of Iatrogenically Pushed Pulp Stone From Middle Third of Root Canal in Permanent Maxillary Central Incisor: A Case Report.

The pulp stones are the discrete nodular calcified masses commonly existing in coronal and occasionally in radicular pulp, placed freely, attached or embedded into the dentine. The present case report revealed the iatrogenic pushing of pulp stone and blockage of root canal that caused endodontic failure. The case enlightens the proper use of ultrasonic instruments with irrigating solutions to manage the calcifications in root canal for successful endodontic therapy.

Orthodontic extrusion of subgingivally fractured tooth using a removable appliance: an alternative treatment to reestablish biological width.

Restoration of a traumatically injured tooth presents a clinical challenge for a predictable aesthetic outcome. This case report describes a multidisciplinary approach of a subgingivally fractured permanent maxillary central incisor. A removable orthodontic appliance was used for orthodontic extrusion of root, and surgical gingival recontouring was done with electrocautery to reestablish the biological width. Form and function were restored establishing biological width and esthetics was repaired with porcelain fused to metal crown.

Correlation of morphological variants of the soft palate and Need's ratio in normal individuals: A digital cephalometric study.

PURPOSE: The present study was aimed to investigate the variation of soft palate morphology in different age and gender groups. The correlations of radiographic velar length (VL), velar width (VW), pharyngeal depth (PD), and Need's ratio with soft palate variants were also studied in the North Indian subpopulation. MATERIALS AND METHODS: The study sample consisted of 300 subjects aged between 15 and 45 (mean: 31.32) years. The velar morphology on lateral cephalograms was examined and grouped into six types. The results obtained were subjected to a statistical analysis to find the correlation between variants of the soft palate with gender and different age groups. RESULTS: The most frequent type of soft palate was leaf shaped (48.7%), and the least common was crook shaped (3.0%) among both the genders and various age groups, showing a significant correlation. The mean VL, VW, and PD values were significantly higher in males and significantly correlated with the types of soft palate. A significant correlation was observed between the mean VL, VW, PD, and Need's ratio with various age groups, showing an inconsistent pattern with an increase in age. The types of soft palate, gender, and Need's ratio were also significantly correlated, with an overall higher mean value of the Need's ratio among female subjects and the S-shaped soft palate. CONCLUSION: The knowledge of a varied spectrum of velar morphology and the variants of the soft palate help in a better understanding of the velopharyngeal closure and craniofacial anomalies.